SENIOR Q&A: Winter care

Tuesday

Sep 12, 2017 at 4:47 PMSep 12, 2017 at 4:47 PM

Q: Now that it is fall I am trying to plan ahead for the winter. My mother lives alone and last winter was lonely and difficult for her. I found myself visiting more, worried about her having enough food if there was a blizzard, her stepping on her stoop to get her mail etc. Do you have any ideas on ways to keep my mother safe during the winter months?

A: Yes there are a couple of ideas. One thought is to consider calling a home care agency to discuss services in your mother’s house. They can prepare meals, go food shopping, get the mail, put out the rubbish can on trash day and bring it back inside, etc. It is not always easy for some seniors to accept help but possibly presenting it as a temporary solution just for the winter. Of course services can stay beyond the winter but maybe if you use the word temporary your mother may say yes. The other idea is to consider moving your mother into an Assisted Living for one month or maybe two during the winter under what is called a ‘respite program.’ This allows people to come in and try the Assisted Living. The rooms are furnished so all your mother needs to bring is her clothes and her medications. There are three meals, social activities, and staff around if your mother should need help. It is private pay and is a nice way to have a break for the winter. It is important to call several facilities and discuss with the admissions coordinator how their respite program works, how long is the max that someone can stay on respite, what are all the costs etc. If you need help finding the Assisted Living that will meet your mother’s needs call us or an Aging Life Specialist in your local area.

Q: My aunt needs to move into a Nursing Home. She will be eligible for Medicaid on the day she moves into the facility. I am having a difficult time finding a nursing home because of her finances. After talking to several people can you explain the reimbursement rate under Medicaid and if the rate is going to be increased?

A: The Medicaid rate is a low rate based on the cost of living in 2007. The 2007 rate does not reflect the inflationary increases for health insurance, energy, food, and capital improvements. According to Massachusetts Senior Care Association the Nursing Homes are being paid less than what it takes to care for each resident on Medicaid; $37 per day below the cost of caring for the resident. Senator Harriet Chandler filed SB336 and Representative Thomas Golden filed HB2072 to increase payments to nursing homes. The bill proposes to increase rates on a yearly basis to reflect inflation costs. With additional monies this proposed legislation will allow facilities to pay higher wages and provide a higher quality of care. There are other pieces to this legislation that would include establishing a career ladder for employees. If your aunt is working with an elder law attorney inform the facility of the name of the attorney. Many times if the facility has made contact with an elder law attorney they will admit someone who is applying for Medicaid. The facilities want to have as much of a guarantee as possible that the application will be approved retroactively so they can be paid. Once the Medicaid application is submitted it can take 4-8 months for that final approval. It is a long time for facilities to wait to get paid.

Q: My father now lives in an Assisted Living. He has adjusted well and has made a few friends. There is one resident that continues to try to sit next to him, will follow my father and go into his room without an invitation, interrupt him when he is talking to someone else and is intrusive. I do not think this person is aware of what he is doing but it bothers my father. We have told my father to ignore it but my father believes this person is personally going after him. What can I do to help my father?

A: It is important to call a care plan meeting at the facility to discuss this situation with the entire team. Let them know that this is upsetting your father. Listen for solutions from the team. This is not for your father to manage (he is in an Assisted Living because he needs oversight and care). This is for the facility to manage. Inform your father of the solution to the problem. If it is not resolved even after a first attempt, then go back to the drawing board with the team to come up with other solutions. Most likely this person is being intrusive to others which is why the facility needs to find a way to solve this problem.

Debbie Gitner, LCSW, C-SWCM, is vice president of the New England Chapter of Geriatric Care Managers. Linda Sullivan, R.N., C.M.C., is a registered nurse and certified care manager. Together they are owners of ElderCare Resource Services in Marlborough, helping families navigate resources for seniors. Contact them at 508-879-7008; toll free at 866-280-2308 or visit eldercareresourceservices.com.